Designing a senior living facility with memory care: Designer Forum - Jan 2016

By Jennifer Schuster

In late 2014, Maplewood Senior Living unveiled its new Maplewood at Stony Hill community building in Bethel, Connecticut, the only assisted living community in northern Fairfield County fully dedicated to caring for residents with Alzheimer’s disease and related dementias. While this level of specialized support is becoming more prevalent, design processes and strategies for these environments with regard to flooring and other interior finishes are not quite set in stone.

THE CHALLENGE OF SENIOR LIVING DESIGN
While myriad considerations are required in the design of a senior living community, interior finishes, such as flooring, are among the most complex. Proper flooring specification is integral to the creation of an optimal care environment for elders, even more so when that environment serves seniors who require assisted living services and memory support. Designers must look beyond what is aesthetically pleasing or even most comfortable underfoot. They must consider which materials perform well within a care environment that is heavily trafficked by residents, care staff and frequent visitors, while also creating an environment that feels more like a private home than a nursing home. 

Maplewood Senior Living, headquartered in Westport, Connecticut, partnered with Perkins Eastman to provide architecture and interior design services and to carry out the care provider’s vision for delivering levels of care based on individual needs. The design team was tasked with crafting an intimate residential setting for the occupants within a sprawling, three-story building equipped with 84 apartments and a host of common spaces. 

From the outside, the new building’s façade is comprised of stone and sliding gables that evoke a New England-style inn nestled into the countryside. That mood is reflected on the inside as well, where groupings of apartments are clustered into smaller households, two per floor, each with its own vestibule, living space and activity areas, plus a large dining room and display kitchen on each floor. This configuration, and variations on it, has become known as the neighborhood model. 

The planning and layout of designing such a facility is challenging enough, which can lead some designers—not to mention care providers—to avoid consideration of interior finishes until much later in the design phase. But the success of this building type, in terms of its ability to positively impact residents’ lives and wellbeing, hinges on determining that level of detail in the early stages of development. Creating a successful neighborhood model requires a unique balancing act in terms of flooring and interiors. A variety of types, textures and patterns should be used so that each neighborhood maintains its own identity, but a degree of compatibility should be applied throughout the building as well. This can be accomplished, for example, with colors and tones that are known to be senior friendly.

SOLUTIONS THROUGH FLOORING 
At Maplewood, a mix of carpeting, luxury vinyl planks and ceramic tiles were configured into the building’s floor plans even before construction began, along with a single application of hardwood in the main lounge. Wood-look LVT and carpet were specified for the dining and living areas. LVT was chosen for exam rooms and pre-function areas. Carpet was specified for resident units, corridors and lobbies, while ceramic tile was installed in the unit bathrooms and the four-season porches. 

Sheet vinyl has long been valued as a cost-friendly, low maintenance solution for care environments, particularly in nursing homes, and more recently LVT has been considered a practical solution for senior care as well. It is low maintenance, easy to install and even easier to clean. 

Carpet has come a long way, both stylistically and technologically, and the flooring choices at Maplewood at Stony Hill offer strong contemporary examples. The rule of thumb for carpeting in senior living environments is the bolder the pattern, the more neutral the color palette. Bold pattern and bold color together are simply too distracting and compromise the tranquil atmosphere that assisted living memory support homes like Maplewood are designed to offer. Likewise, carpet with too much contrast may also cause visual movement issues for residents. Yet it’s also important to create a palette that’s interesting, not bland or neutral, as a means of increasing vibrancy within the space. 

In one of the floor’s main dining rooms, as well as one household’s central living room, large carpet tiles are framed by a perimeter of rustic wood LVT planks, lending to these areas a clean juxtaposition of soft and hard surfaces while avoiding any sudden transitions that could lead to tripping or disorientation for residents. This was accomplished by the use of carpet tiles that feature a lower profile and a distinct pattern to offset the wood tiles, including Curtain Call from J+J Invision. 

The adjoining corridors and adjacent apartments were fitted with carpet as well, including J+J Invision’s Cameo broadloom, with patterns that are complementary but not identical to those utilized in the common areas. Carpet with solution-dyed yarns allows for cleaning with bleach, and antimicrobial coatings prevent bacterial growth. Many carpet types are also equipped with a moisture barrier backing to prevent the absorption of liquids and lingering odors. Carpet tile allows designers to create a residential feel while facilitating easy maintenance. Carpet has increasingly become a preferred flooring among care providers who recognize that it more closely resembles what most residents have in their own homes, lending to the support environment a sense of calm and intimacy that is more boutique hotel than healthcare facility.

CATERING TO HEARING IMPAIRMENTS
Research has shown that acoustics should be a major consideration in the designing of public spaces where those with hearing impairments spend time. Too many hard surfaces create spaces that are loud, resulting in a level of discomfort and hearing challenges for some. At Maplewood, fabric-wrapped wall panels were used to offset hard surfaces and help absorb sound, and in the main lobby an acoustical underlayment was installed under the hardwood flooring.

In auditoriums and other multipurpose rooms where hard surfaces are in abundance, sound panels installed in the ceiling combined with an assistive listening system create an optimal entertainment space for those with hearing impairments. Noise-absorbing acoustical flooring underlayments can also prevent excess sound from transmitting to floors below. All of these factors not only contribute to the overall enjoyment of a movie or live performance, but also enhance the quality of care for residents. With careful consideration, flooring and other finishes can work together to improve day-to-day experiences for older adults. If those finishes are chosen and applied haphazardly, they can actually become countermeasures and exacerbate residents’ impaired sight, hearing, memory or other faculties.

MATERIALS THAT PROMOTE HEALTH
The quality of care and supportive services in senior living, particularly when based on the neighborhood model, hinges on several factors, the most obvious being a building’s floor layout and the configuration of common areas where residents regularly convene—such as dining rooms, living rooms, salons and outdoor courtyards—in relation to private rooms and entranceways. The building’s physical orientation is another crucial factor, obligating designers to consider how certain vantage points to the outdoors will impact residents’ daily lives. 

The attributes of the buildings themselves, both interior and exterior, while often deemed important, are not so commonly associated with quality of care. However, material health and resident health are very much interconnected. Interior finishes—from flooring products with recycled content and low VOCs to the cleaning solutions needed to maintain the various surfaces—can have a positive impact on the level of care provided. In addition, antimicrobial coatings on the carpeting can lead to improved respiratory health, soothing color palettes applied along the corridors can lead to improved mental health, and pleasing combinations of surface patterns in common areas can lead to improved social health.

The selection of flooring and other finishes is most successful when the entire project team works together from the beginning of the project and considers multiple factors during the selection phase, such as maintenance, material content relating to residential health, aesthetics, transitions and cost. Maplewood at Stony Hill is a prime example of the integration of architecture and interior design to create a quality home for older adults focused on optimal living.